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==Causes==
==Causes==
Leiter and Maslach found the following antecedents using factor analysis:<ref name="Leite20093">Leiter, Michael P., and Christina Maslach. "Areas of worklife: A structured approach to organizational predictors of job burnout." Emotional and physiological processes and positive intervention strategies. Emerald Group Publishing Limited, 2003. 91-134. {{doi|http://dx.doi.org/10.1016/S1479-3555(03)03003-8}}</ref>
Leiter and Maslach found the following antecedents using factor analysis:<ref name="Leite20093">Leiter, Michael P., and Christina Maslach. "Areas of worklife: A structured approach to organizational predictors of job burnout." Emotional and physiological processes and positive intervention strategies. Emerald Group Publishing Limited, 2003. 91-134. {{doi|10.1016/S1479-3555(03)03003-8}}</ref>
* Workload
* Workload
* Fairness
* Fairness
Line 98: Line 98:


Of these causes, workload is the strongest correlate of emotional exhaustion<ref name="Leite20093"/>. Perceived control or autonomy and fairness correlate with cynicism.<ref name="Leite20093"/><ref name="Fernet Austin Trépanier Dussault 2013 pp. 123–137">{{cite journal | last=Fernet | first=Claude | last2=Austin | first2=Stéphanie | last3=Trépanier | first3=Sarah-Geneviève | last4=Dussault | first4=Marc | title=How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness | journal=European Journal of Work and Organizational Psychology | publisher=Informa UK Limited | volume=22 | issue=2 | year=2013 | issn=1359-432X | doi=10.1080/1359432x.2011.632161 | pages=123–137}}</ref>
Of these causes, workload is the strongest correlate of emotional exhaustion<ref name="Leite20093"/>. Perceived control or autonomy and fairness correlate with cynicism.<ref name="Leite20093"/><ref name="Fernet Austin Trépanier Dussault 2013 pp. 123–137">{{cite journal | last=Fernet | first=Claude | last2=Austin | first2=Stéphanie | last3=Trépanier | first3=Sarah-Geneviève | last4=Dussault | first4=Marc | title=How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness | journal=European Journal of Work and Organizational Psychology | publisher=Informa UK Limited | volume=22 | issue=2 | year=2013 | issn=1359-432X | doi=10.1080/1359432x.2011.632161 | pages=123–137}}</ref>
* 16% of burnout is attributed to perceived control at the worksite.<ref>Taris, Toon W., et al. "Job control and burnout across occupations." Psychological Reports 97.3 (2005): 955-961. {{doi|10.2466/pr0.97.3.955-961}}</ref>


These find9ings are reflected in the Demand-Control theory of job stress.
These findings are reflected in the Demand-Control theory of job stress.
<ref name="Karasek 1990 p. ">{{cite book | last=Karasek | first=Robert | title=Healthy work : stress, productivity, and the reconstruction of working life | publisher=Basic Books | publication-place=New York | year=1990 | isbn=0-465-02897-7 | page=}}</ref>
<ref name="Karasek 1990 p. ">{{cite book | last=Karasek | first=Robert | title=Healthy work : stress, productivity, and the reconstruction of working life | publisher=Basic Books | publication-place=New York | year=1990 | isbn=0-465-02897-7 | page=}}</ref>
==Prevention==
==Prevention==


Revision as of 01:13, 11 September 2017

Template:Otheruses4 Template:DiseaseDisorder infobox Burnout is a psychological term for "an excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure".[1] Burnout has three dimensions[2]:

  • Emotional exhaustion
  • Depersonalization (cynicism)
  • Diminished personal accomplishment (inefficacy)

Subsequent research suggests the third dimension, personal accomplishment, better fits with the concept of professional engagement rather than with burnout.[3]

The prevalence of burnout in the general, employed population of the United States, aged is[4][5][6]:

  • General, employed U.S. population
    • (2010): aged 31-47 30%[4], aged 29-65 29%[5]
    • (2014): aged 31-65 28%[6]
  • College graduates 2010: aged 31-47 36%[4]

Burnout is now being studied in its reported antitheses, job satisfaction, job engagement and thriving. Thriving may protect against burnout.[7][8] However, unhealthy engagement may lead to burnout.[9]

Health care workers

As many as 50% of physicians in practice may have burnout.[6] General practitioners seem to have low job control and the highest proportion of burnout cases[10].

For physicians in training, rates of burnout (emotional exhaustion) for students, residents and fellows is about 50% while the rate is 36% in similarly aged college graduates.[4] Burnout in physicians in training is associated with perceived harassment[11]. In one survey of 24 American medical schools, harassment occurring at least one time was reported by 83% of students[11]. In this study, harassment was more commonly reported being perpetrated by residents[11]. The rates of burnout among students responding to the survey were[11]:

  • All students 34%
  • Those reporting recurrent harassment by faculty 57%
  • Those not reporting recurrent harassment by faculty 32%

According to the yearly survey of recent medical school graduates by the Association of American Medical Colleges, the following are reported [12]:

  • Occasional public embarrassment 20%
  • Occasional public humiliation 8%

Measurement

Maslach Burnout Inventory

The Maslach Burnout Inventory is the earliest and most well-studied measurement of burnout. Maslach and her colleague Jackson first identified the construct "burnout" in the 1970s, and developed a measure that weighs the effects of on three scales[2]:

  • Emotional exhaustion (nine items)
  • Depersonalization (five items)
  • Personal accomplishment (eight items)

2 item burnout Inventory

In this survey, abnormal is defined as symptoms weekly or more on either item.[13][14] The first item correlates with emotional exhaustion.

1. I feel burned out from my work[14] or How often do you feel burned out from your work?[13]

  • Never
  • A few times a year or less
  • Once a month
  • A few times a month
  • Once a week
  • A few times a week
  • Every day

2. I have become more callous toward people since I took this job[14] or How often do you feel you’ve become more callous toward people since you started your residency?[13]

  • Never
  • A few times a year or less
  • Once a month
  • A few times a month
  • Once a week
  • A few times a week
  • Every day

The two item format has been used in national surveys in 2011[5] and its follow-up survey in 2014[6].

Mini Z

The Mini Z[15] was adapted from earlier work by Rohland[16] and Schmoldt[17] and the Physician Worklife Survey[18]. The Mini Z is a single item (burnout is defined as answers c, d, or e) that correlates with the emotional exhaustion scale of the Maslach[16]:

1. Using your own definition of “burnout,” please circle one of the answers below:

a. I enjoy my work. I have no symptoms of burnout.

b. I am under stress, and don’t always have as much energy as I did, but I don’t feel burned out.

c. I am definitely burning out and have one or more symptoms of burnout, e.g., emotional exhaustion.

d. The symptoms of burnout that I am experiencing won’t go away. I think about work frustrations a lot.

e. I feel completely burned out. I am at the point where I may need to seek help.

The Mini Z is promoted by the American Medical Association's Steps Forward campaign.[19]

The Mini Z may report lower prevalence of burnout than when measured by the full Maslach Burnout Inventory (MBI).[20]

Copenhagen Burnout Inventory

The Copenhagen Burnout Inventory is another scale and was developed in 2005.[21]

Physician Well-Being Index (PWBI)

The PWBI contains 7 items, one of which queries burnout in a yes/no response format. Its development[22] and application[23] have been reported.

Causes

Leiter and Maslach found the following antecedents using factor analysis:[24]

  • Workload
  • Fairness
  • Control
  • Community
  • Values
  • Rewards

Of these causes, workload is the strongest correlate of emotional exhaustion[24]. Perceived control or autonomy and fairness correlate with cynicism.[24][25]

  • 16% of burnout is attributed to perceived control at the worksite.[26]

These findings are reflected in the Demand-Control theory of job stress. [27]

Prevention

Thriving[7][8] and engagement[3] are negatively correlated with, and thus may be protective, against burnout. However, unhealthy engagement may lead to burnout.[9]

Perceived control or autonomy and fairness correlate with cynicism.[24][25]

See also

References

  1. ↑ Anonymous (2024), Professional Burnout (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 2.0 2.1 Maslach, Christina; Jackson, Susan E. (1981). "The measurement of experienced burnout". Journal of Organizational Behavior. Wiley-Blackwell. 2 (2): 99–113. doi:10.1002/job.4030020205. ISSN 0894-3796.
  3. ↑ 3.0 3.1 Schaufeli, Wilmar B.; Bakker, Arnold B.; Salanova, Marisa (2016). "The Measurement of Work Engagement With a Short Questionnaire". Educational and Psychological Measurement. 66 (4): 701–716. doi:10.1177/0013164405282471. ISSN 0013-1644.
  4. ↑ 4.0 4.1 4.2 4.3 Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J; et al. (2014). "Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population". Acad Med. 89 (3): 443–51. doi:10.1097/ACM.0000000000000134. PMID 24448053.
  5. ↑ 5.0 5.1 5.2 Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D; et al. (2012). "Burnout and satisfaction with work-life balance among US physicians relative to the general US population". Arch Intern Med. 172 (18): 1377–85. doi:10.1001/archinternmed.2012.3199. PMID 22911330.
  6. ↑ 6.0 6.1 6.2 6.3 Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J; et al. (2015). "Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014". Mayo Clin Proc. 90 (12): 1600–13. doi:10.1016/j.mayocp.2015.08.023. PMID 26653297.
  7. ↑ 7.0 7.1 Porath, Christine, et al. "Thriving at work: Toward its measurement, construct validation, and theoretical refinement." Journal of Organizational Behavior 33.2 (2012): 250-275. doi:10.1002/job.756
  8. ↑ 8.0 8.1 Hildenbrand K, Sacramento CA, Binnewies C (2016). "Transformational Leadership and Burnout: The Role of Thriving and Followers' Openness to Experience". J Occup Health Psychol. doi:10.1037/ocp0000051. PMID 27631555.
  9. ↑ 9.0 9.1 Vinje HF, Mittelmark MB (2007). "Job engagement's paradoxical role in nurse burnout". Nurs Health Sci. 9 (2): 107–11. doi:10.1111/j.1442-2018.2007.00310.x. PMID 17470184.
  10. ↑ Taris TW, Stoffelsen J, Bakker AB, Schaufeli WB, van Dierendonck D (2005). "Job control and burnout across occupations". Psychol Rep. 97 (3): 955–61. doi:10.2466/pr0.97.3.955-961. PMID 16512316.
  11. ↑ 11.0 11.1 11.2 11.3 Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD (2014). "The prevalence of medical student mistreatment and its association with burnout". Acad Med. 89 (5): 749–54. doi:10.1097/ACM.0000000000000204. PMC 4401419. PMID 24667503.
  12. ↑ Association of American Medical Colleges. Medical School Graduation Questionnaire: All Schools Summary Report. Association of American Medical Colleges; Washington, DC
  13. ↑ 13.0 13.1 13.2 West CP, Shanafelt TD, Kolars JC (2011). "Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents". JAMA. 306 (9): 952–60. doi:10.1001/jama.2011.1247. PMID 21900135.
  14. ↑ 14.0 14.1 14.2 West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD (2012). "Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment". J Gen Intern Med. 27 (11): 1445–52. doi:10.1007/s11606-012-2015-7. PMC 3475833. PMID 22362127.
  15. ↑ Linzer M, Poplau S, Babbott S, Collins T, Guzman-Corrales L, Menk J; et al. (2016). "Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey". J Gen Intern Med. 31 (9): 1004–10. doi:10.1007/s11606-016-3720-4. PMC 4978678. PMID 27138425.
  16. ↑ 16.0 16.1 Rohland, Barbara M.; Kruse, Gina R.; Rohrer, James E. (2004). "Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians". Stress and Health. 20 (2): 75–79. doi:10.1002/smi.1002. ISSN 1532-3005.
  17. ↑ Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract. 1994 Jun;8(2):58-63. PMID: 1013526
  18. ↑ Konrad TR, Williams ES, Linzer M, McMurray J, Pathman DE, Gerrity M; et al. (1999). "Measuring physician job satisfaction in a changing workplace and a challenging environment. SGIM Career Satisfaction Study Group. Society of General Internal Medicine". Med Care. 37 (11): 1174–82. PMID 10549620.
  19. ↑ Linzer, Mark; Guzman-Corrales, Laura; Poplau, Sara. "Preventing physician burnout - STEPS Forward". STEPSforward.org. Retrieved 2017-05-24.
  20. ↑ Linzer M, Poplau S (2017). "Building a Sustainable Primary Care Workforce: Where Do We Go from Here?". J Am Board Fam Med. 30 (2): 127–129. doi:10.3122/jabfm.2017.02.170014. PMID 28379818.
  21. ↑ CKristensen T, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207 doi:10.1080/02678370500297720
  22. ↑ Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. J Gen Intern Med. 2013 Mar;28(3):421-7. doi: doi:10.1007/s11606-012-2252-9. PMID: PMID 23129161
  23. ↑ Dyrbye LN, Satele D, Shanafelt T. Ability of a 9-Item Well-Being Index to Identify Distress and Stratify Quality of Life in US Workers. J Occup Environ Med. 2016 Aug;58(8):810-7. doi: doi:10.1097/JOM.0000000000000798. PMID: PMID 27294444
  24. ↑ 24.0 24.1 24.2 24.3 Leiter, Michael P., and Christina Maslach. "Areas of worklife: A structured approach to organizational predictors of job burnout." Emotional and physiological processes and positive intervention strategies. Emerald Group Publishing Limited, 2003. 91-134. doi:10.1016/S1479-3555(03)03003-8
  25. ↑ 25.0 25.1 Fernet, Claude; Austin, Stéphanie; Trépanier, Sarah-Geneviève; Dussault, Marc (2013). "How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness". European Journal of Work and Organizational Psychology. Informa UK Limited. 22 (2): 123–137. doi:10.1080/1359432x.2011.632161. ISSN 1359-432X.
  26. ↑ Taris, Toon W., et al. "Job control and burnout across occupations." Psychological Reports 97.3 (2005): 955-961. doi:10.2466/pr0.97.3.955-961
  27. ↑ Karasek, Robert (1990). Healthy work : stress, productivity, and the reconstruction of working life. New York: Basic Books. ISBN 0-465-02897-7.
  • ”Sources of Management of Excessive Job Stress and Burnout”, In P. Warr (Ed.), Psychology at Work Fourth Edition. Penguin.
  • “Tailoring treatment strategies for different types of burnout” Farber, B. A. (1998). Paper presented at the Annual Convention of the American Psychological Association, 106th, San Francisco California, August 14-18. ED 424 517
  • “Staff burnout”, Freudenberger, H. J. (1974). Journal of Social Issues, 30(1), 159-165.
  • “Authentic leaders creating healthy work environments for nursing practice”, Shirey MR. American Journal of Critical Care May 2006. Vol. 15, Iss. 3; p. 256
  • “Taming burnout's flame”, Krista Gregoria Lussier, Nursing Management Chicago: Apr 2006. Vol. 37, Iss. 4; p. 14
  • “A Scientific Solution To Librarian Burnout”, Craig S. Shaw New Library World Year 1992 Volume: 93 Number: 5
  • Stress and Burnout in Library Service, Caputo, Janette S. Phoenix, AZ: Oryx Press, 1991.
  • An assessment of burnout in academic librarians in America using the Maslach Burnout Inventor (the MBI) Ray, Bernice, Ph.D., Rutgers University - New Brunswick, 2002, 90 pages; AAT 3066762


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